1. POLICY 1.1. To insure prompt and effective medical assistance is provided to the employees of MAPP in case of workplace injury or illness, the following first aid and medical serices procedure is provided 1.2. It is the responsibility of each superintendent and project manager to assure that compliance to the First Aid And Medical Services Procedure is provided 2. PURPOSE 2.1. This First Aid and Medical Services Procedure is designed to establish specific common guidelines for MAPP work sites to follow in assuring that prompt medical attention is provided to employees suffering from either a work related or non-work related injury or illness. 2.2. Each MAPP facility and jobsite must ensure that readily available medical personnel and first aid supplies are available to all employees to provide advice and consultation within reason, regarding matters of employee occupational health and to respond in case of accident. This includes identifying and posting the location of a designated medical treatment facility and/or emergency care center in a conspicuous location at each fixed location or fixed jobsite. Should outside medical services be unable to respond in a reasonable amount of time as defined by OSHA (3 to 4 minutes). The MAPP facility and jobsite sh9ould have a first aid/cpr trained person on site. 3. Established Medical Treatment Facility means the occupational medical treatment provider and/or emergency care center identified as being capable of, and established by a MAPP location to initially treat employee injuries and illnesses. 4. First Aid means the following types of treatment: 4.1. Using non-prescription medications at non-prescription strength 4.2. Cleaning, flushing, or soaking wounds on the skin surface 4.3. Using wound coverings, such as bandages, Band Aids, gauze pads, etc. or using Steri Strips or butterfly bandages 4.4. Using hot or cold therapy 4.5. Using any totally non-rigid means of support, such as elastic bandages, wraps, etc. 4.6. Using temporary immobilization devices while transporting an employee, such as splints, slings, neck collars, or back boards. 4.7. Drilling a fingernail or toenail to relieve pressure, or draining fluids from blisters 4.8. Using eye patches 4.9. Using simple irrigation or a cotton swab to remove foreign bodies not embedded in or adhered to the eye 4.10. Using irrigation, tweezers, cotton swab or other simple means to remove splinters or foreign materials from areas OTHER than the eye 1
2 4.11. Using finger guards 4.12. Using massages 4.13. Drinking fluids to relieve heat stress 5. Illness can be classified as a skin disease/disorder, respiratory condition, poisoning, or other illness resulting from an event in the work environment. Examples include, but are not limited to: 5.1. Contact dermatitis 5.2. Eczema 5.3. Silicosis 5.4. Asbestosis 5.5. Toxic inhalation 5.6. Poisonings by lead, mercury, or other metals 5.7. Poisonings by carbon monoxide, hydrogen sulfide, or other gases 5.8. Poisonings by organic solvents or by other chemicals 5.9. Heatstroke, sunstroke, heat exhaustion, or other heat-related factors 5.10. Freezing, frostbite, or other cold-related factors 5.11. Effects of non-ionizing radiation (welder s flash or lasers) 5.12. Bloodborne pathogenic diseases 5.13. Microbial Exposure 5.14. Ionizing Radiation 6. Injury means any wound or damage to the body resulting from an event in the work environment. Examples include: 6.1. Cut/laceration 6.2. Puncture 6.3. Abrasion 6.4. Contusion/bruise 6.5. Fracture 6.6. Chipped tooth 6.7. Amputation 6.8. Insect bite 6.9. Electrocution 6.10. Thermal, chemical, electrical, or radiation burn 6.11. And, sprain/strain injuries to muscles, joints and connective tissues when the result from a slip. Trip, fall or other similar accident. 7. Medical Treatment means the managing and caring for a patient for the purpose of combating disease or disorder. The following activities are NOT medical treatment: 7.1. First aid 7.2. Visits to a doctor solely for observation or counseling
7.3. Diagnostic procedures, including the administering of prescription medications that are used solely for diagnostic procedures 8. Work-related Injury or Illness means an injury or illness resulting from an event or exposure in the work environment causing or contributing to the condition or significantly aggravating a preexisting condition. 9. Work Environment includes work sites where one or more employees are present as a condition of their employment. 10. REQUIREMENTS 10.1. Designated Medical Treatment Facility 10.1.1. MAPP will ensure that readily available medical personnel are available to employees to provide advice and consultation within reason regarding matters of employee occupational health. 10.1.2. Each fixed facility and fixed jobsite must identify and post the location of a designated medical treatment area and the closest emergency care center including name, address, telephone number, and hours of operation. This information should be posted in a conspicuous location at each fixed facility or fixed job site. The designated medical treatment facility or emergency care center should maintain similar hours of operation as the facility and be able to respond to a workplace emergency within a reasonable amount of time. All medical transportation shall be done by MAPP Supervision unless there is a life threatening condition in which case ambulance service shall be used. 11. First Aid 11.1. ALL INJURIES, REGARDLESS OF HOW SMALL, MUST BE REPORTED TO THE EMPLOYEE S IMMEDIATE SUPERVISOR AND TREATED AS SOON AS POSSIBLE AFTER AN ACCIDENT. 11.2. If an employee becomes injured or ill anywhere due to a work-related or nonwork-related problem and needs immediate medical aid, it must be reported to his/her Supervisor or the MAPP Superintendent. Failure to report minor injuries or to receive supervised medical treatment may result in serious infections or complications to the employee s health. 11.3. In the absence of a clinic or hospital near the workplace, OSHA regulations require that a person or persons be trained to render first aid that that first aid supplies be readily available. 11.4. Because of the potential for exposure to bloodborne pathogens and significant liability concerns, there is no job in the Company that requires an employee to render 3
First Aid or cardiopulmonary resuscitation (CPR) in the course and scope of their employment, unless such a requirement becomes necessary due to local, State or Federal Safety and Health Regulations. 11.5. When MAPP s strategy for providing access to First Aid/CPR involves the use of first responders, a First Responders Program should be established and administered at the local level. All MAPP Superintendent and Project Managers will be first aid and CPR certified. 12. Elements of the First Responder Program should include: 12.1.1.1. All responsible persons must be certified in basic First Aid & CPR per a recognized certification source such as the Red Cross, local hospital, etc. 12.1.1.2. Basic First Aid and CPR will be administered by First Responders only to stabilize the employee until professional medical attention can be provided. 12.1.1.3. Due to the potential occupational exposure to First Responders, it is the responsibility of the superintendent or his/her designee to follow the Bloodborne Pathogen Exposure Control Program. 13. Employee First Aid/CPR 13.1. Employee training in basic First Aid and cardiopulmonary resuscitation (CPR) is encouraged because of its value and benefit to individuals, their families and the community. 13.2. The company also supports any employee who, while on the job, chooses to act as a Good Samaritan to assist a fellow employee or another person with First Aid or CPR. It is MAPP s intent that First Aid supplies and basic personal protective equipment against bloodborne pathogens be accessible to employees at every work site during all shifts. 13.3. If an employee makes the decision to provide First Aid to someone, universal precautions shall be followed and it should be assumed that all blood and bodily fluids are contaminated with bloodborne pathogens. In addition, they should wear protective medical gloves found in the First Aid Kit and use any other personal protective equipment (such as protective glasses with sideshields or a full face shield) to help avoid exposure to blood in the eyes or on the face. 13.4. First Aid providers should follow the example of emergency medical personnel, doctors and nurses who wear personal protective equipment to prevent exposure to bloodborne pathogens. 13.5. If blood or potentially contaminated material gets on the skin, it must be washed off immediately using water and a non-abrasive soap. If available, an antiseptic soap or rinse must be used. If blood ever gets in the eyes, lips, mouth or nose, the employee must go to a sink, water fountain, eye wash or body wash station and flush the area with running water as quickly as he/she can. 4
14. First Aid Stations/First Aid Kits 14.1. A First Aid Station or First Aid Kit is to be readily available to employees as described previously. Whether within the facility or in a vehicle, each First Aid Kit must be stored in a properly labeled weather-proof container, stocked with the basic supplies appropriate for the hazards present on the project site. These items should be in individually sealed packages. The physician s approval of the inventory list is not required, but may be needed to address unusual exposure situations. 14.2. IMPORTANT: If an employee declines First Aid and/or medical treatment for a reported on-the-job injury after the Supervisor recommends it, that employee should NOT be allowed to continue work. Supervisors should discuss each situation with the Safety Department and have the employee sign a declination of medical treatment form before allowing that employee to return to duty. 14.3. Each superintendent is responsible for checking and maintaining the First Aid Cabinet and its contents at least weekly. Supervisors on jobsites are responsible for assuring suitable supplies are provided in the First Aid Kits on-site. This person will take a weekly inventory of supplies and make sure the station or kit remains adequately stocked. 15. Emergency Eye/Body Wash Stations 15.1. Where the eyes and/or body of any employee may be exposed to injurious chemical/corrosive materials, suitable eye and/or body drenching and/or flushing facilities shall be provided whether at a client s facility or at a temporary worksite. Emergency eye and/or body wash stations can be either of temporary or permanent installation. 15.2. In areas where the extent of possible exposure to injurious chemical/corrosive materials is very low, a specially designated pressure controlled and identified water hose can be used when proper personal protective equipment is also used (e.g. full face shield). The hose system must be equipped with a proper face and body wash nozzle and provide copious amounts of low velocity potable water. An appropriate eye wash device containing not less than one gallon of potable water would also be acceptable under these conditions. 15.3. Inspection and maintenance of eye wash systems should be provided at least weekly by assuring sanitary conditions and/or following the manufacturer s requirements for maintenance. Plumbed systems should also be provided a water flow test to minimize contaminants in the line. Inspection and maintenance should be properly documented. 16. Bloodborne Pathogens (Universal) Precautions Training 16.1. When an employee comes into direct contact with blood, bodily fluids or body tissues of another person, they are at risk of becoming infected with diseases that may 5
be carried in the other person s body fluids. Accidental exposures can happen on or off the work site, in any number of day-to-day situations 16.2. This is why the Company believes that each employee should have a basic understanding and awareness of the dangers of contracting a potentially deadly disease through such exposures. Communicating basic information about these hazards, including information contained in this policy, is a part of the Company s safety and health program. 16.3. Therefore, employees should receive a basic awareness level training concerning Universal Precautions such that employees may follow Universal Precautions in the event of potential exposure to blood or other body fluids 17. TRAINING REQUIREMENTS 17.1. Training records must be maintained by the Safety Department containing the date of the training, a summary of the training session, names and qualifications of the instructors conducting the training and the names and job titles of the persons attending the training 17.2. Training records must be maintained for a minimum of three (3) years from the date the training was conducted. Training must be conducted by a qualified and competent person knowledgeable in the subject matter. 6